Arthritis is an inflammatory condition, which is characterized by pain, inflammation, and a reduced range of motion. When one is diagnosed with this condition, the rheumatologist will most likely recommend medication, physical therapy and lifestyle changes such as avoiding foods that could trigger inflammation.
According to Science Daily report, several previous studies have demonstrated that moderate alcohol consumption is linked with less severe disease and better quality of life in patients with rheumatoid arthritis, but a new Arthritis Care & Research study suggests that this might not be because drinking alcohol is beneficial.
In the 16,762-patient study, patients with higher severity of disease were more likely to discontinue the use of alcohol and less likely to initiate use, and patients with greater disability and poor physical and mental quality of life were less likely to use alcohol over time. Also, alcohol use or recent changes in use were not associated with disease activity or death when considering the underlying factors influencing the behavior. Materials provided by Wiley. Note: Content may be edited for style and length.
Is alcohol one of these lifestyle changes? There are some relationships and links that you should know about with alcohol and arthritis, which are detailed below.
Let’s find out!
Overview of arthritis
Here are some of the most important facts to remember about arthritis:
- Joints become inflamed, leading to pain, warmth, and redness
- Symptoms will prevent one from moving their joints to their maximum range
- There are different types of arthritis, with osteoarthritis and rheumatoid arthritis being the most common
- Frequent causes of arthritis include injury, infection, metabolic problems and an autoimmune cause (autoimmune arthritis or gout)
- Risk factors can include genetics, injury and chronic alcohol consumption
- Diet can either help with the symptoms of arthritis or make them worse (a balanced diet containing foods like omega-3s and curcumin is recommended).
Does alcohol consumption have an effect on arthritis?
Gout, an autoimmune disorder directly related to alcohol
Gout is an autoimmune disorder, which is often caused by the excess consumption of alcohol. Uric acid crystals gather in the joints, most commonly in the hands and feet. The condition can be quite painful and can be temporary, recurrent or chronic.
Studies have shown that alcohol increases the risk of developing gout, due to its high purine content. Purine is the trigger of inflammation and uric acid crystal formation.
The diuretic properties of alcohol can make arthritis worse
Alcohol is a diuretic, meaning that it takes water out of the body, resulting in dehydration. In this case joints are affected, as they require water to stay lubricated and move smoothly.
Alcohol-induced dehydration can aggravate the symptoms of arthritis, or at least make them more obvious. Therefore, it makes sense that frequent alcohol consumption has been associated with a higher risk of developing arthritis.
Alcohol and medication should not be mixed
Rheumatologists advise against the consumption of alcohol in patients who are taking specific medications for arthritis. For example, those taking disease-modifying anti-rheumatic drugs should not drink alcohol of any kind.
The contraindication has to do with a high risk of liver toxicity, as the liver metabolizes some medications and alcohol via the same pathways. NSAIDs or other over-the-counter pain-killers such as acetaminophen should avoid alcohol, as this combination can result in stomach bleeding or liver damage.
For a long period of time, it was believed that one should not consume alcohol while following treatment with methotrexate (for rheumatoid arthritis and other types). This was based on research that showed alcohol increased the risk of liver damage significantly. Recent studies, however, have confirmed that moderate alcohol consumption does not increase this risk, regardless of the type of alcohol (liquor, wine or beer). Alcohol can affect liver health in those taking methotrexate, but moderate consumption is not as dangerous as it was once believed.
Excess quantities of alcohol can trigger inflammation
You may often hear that alcohol can be consumed in moderation, and that is quite true. However, if one decides to consume excess quantities of alcohol, the benefits will be lost. Moreover, the more alcohol one consumes, the easier it will be for inflammation to occur. Simply put, the symptoms of arthritis will become worse.
What is the verdict?
Alcohol definitely plays a role in the signs and symptoms of arthritis. It can trigger inflammation, interact negatively with medication and increase the risk of liver toxicity. In certain cases, it is recommended to give up alcohol altogether.
One should remember that alcohol, especially when consumed in excess, can cause damage to other parts of the body. For instance, alcohol may increase the risk of mouth and throat, esophagus, colon, and breast cancer, and chronic alcohol consumption is associated with a higher risk of diabetes and stroke.
As a general rule, only drink alcohol in moderation and only after you’ve spoken to your doctor. If you have been diagnosed with arthritis and are planning on having a drink or two, you might want to get the specialist’s advice first.
Keep in mind that alcohol is especially a red flag in case of gout. As it is rich in purine it can lead to severe pain, preventing you from engaging in daily living activities. Beer contains high amounts of purine, but wine and some types of liquor do as well.
It is important to remember that a moderate intake of certain types of alcohol such as red wine can benefit damaged joints. Red wine is rich in resveratrol, which is an antioxidant with powerful anti-inflammatory properties. One standard drink of red wine daily has been associated with a reduced risk of both osteo and rheumatoid arthritis.
Moderation is key
Women should not have more than one standard drink per day, while men should have no more than two. The excessive intake of alcohol is not beneficial is anyway, as we have already shown.
If you do decide to drink alcohol, moderation is key. According to Healthline, moderate drinking is defined as one drink a day for women and two drinks a day for men.
One serving is equal to:
- 12 ounces of beer
- 5 ounces of wine
- 1 1/2 ounces of 80-proof distilled spirits
Can alcohol make arthritis worse?
Yes, but it all depends on the medication you are taking for your arthritis and the amount of alcohol you’re drinking, as well as the frequency of consumption.
It is also worth mentioning that each person tolerates alcohol differently. If you have consumed alcohol and noticed that your joints are painful, it might be time to take a step back. Always remember that alcohol is metabolized by the liver and combining this with medication can result in dangerous toxicity.
For those who are interested in consuming alcohol in moderation, your rheumatologist might recommend regular liver function tests. They might also warn about other effects of alcohol such as sleep deprivation and it’s high carbohydrate content that may increase the risk of obesity, which can further damage joints.
If you are not taking medication that can damage the liver and there are no other indications that alcohol affects your health, a drink or two from time to time may be appropriate. But for those who take methotrexate or other medications for arthritis, the liver function tests, as mentioned, are particularly important.
Through regular monitoring, one can find out early if there is a worrisome health issue. Paying attention to your body might also offer information on how well you are doing. For example, stomach pain and heartburn are two symptoms that might indicate GI tract irritation.
If you are experiencing such symptoms on a regular basis, you should consider cutting out alcohol. Chronic alcohol consumption has been confirmed as a risk factor in the development of osteoarthritis and is associated with complications such as liver cirrhosis.
If you suffer from arthritis, it is wise to consult your doctor before drinking alcohol. The rheumatologist will take into account the medication you are currently taking and the possible interaction with alcohol, as well as the risk of liver damage. However, drinking alcohol in moderation is the best solution. You can relax with a glass of wine from time to time, making sure your habits are not making your arthritis worse.
In the case where treatments take a toll on your liver, however, giving up alcohol altogether might be the only road to take.
 Joshua F. Baker, Bryant R. England, Ted R. Mikuls, Jesse Y. Hsu, Michael D. George, Sofia Pedro, Harlan Sayles, Kaleb Michaud. Changes in Alcohol Use and Associations with Disease Activity, Health Status, and Mortality in Rheumatoid Arthritis. Arthritis Care & Research, 2019; DOI: 10.1002/acr.23847
 Wiley. (2019, March 20). Does alcohol consumption have an effect on arthritis?. ScienceDaily. Retrieved August 19, 2019 from www.sciencedaily.com/releases/2019/03/190320102033.htm
 Arthritis Foundation: "Alcohol and Arthritis."
 ACR Meeting Abstracts: “Alcohol Consumption and the Risk of Coronary Heart Disease and Mortality in Patients with Rheumatoid Arthritis."
 Arthritis & Rheumatology: "Alcohol consumption and markers of inflammation in women with preclinical rheumatoid arthritis."
 National Institute on Alcohol Abuse and Alcoholism: "What Is a Standard Drink?"
 The Lancet: "Effect of alcohol consumption on systemic markers of inflammation."